Anti-Anginal Agents

Question 1

NTG (oral spray, patch) MOA

Answer 1

1) Increase myocardial blood supply = increased O2, reduced coronary vasopasm
2) Decrease demand = decreased preload venodilation

Question 2

NTG SEs

Answer 2

• Tachyphylaxis after 24 hrs (avoid w/nitrate free period for 8 hrs)
• H/A, flushing, hypotension

Question 3

NTG Contraindications

Answer 3

• SBP <100

- ED meds - separate 24 hrs d/t severe hypotension (d/t vasodilation)

Question 4

Cardioseclective (B1 only) BB

Answer 4

• Atenolol

- Metoprolol (most selective)

Question 5

Nonselective (B1 & B2) BB

Answer 5

• Propranolol
• Nadolol
• Sotalol

Question 6

BB MOA

Answer 6

1) increase myocardial blood supply = increase O2 by prolonging filling times
2) Decrease O2 demand during exercise/stress

**decreases CO, HR & contractility

Question 7

BB Caution

Answer 7

• *DM pts (masks signs of hypoglycemia)
• Asthma, COPD
• Heart block

Question 8

Non-Dihydropyridine CCB

Answer 8

• Verpamil

- Diltiazem

Question 9

Non-Dihydropyridine CCB MOA

Answer 9

1) increase coronary vasodilation, prolonging filling time

2) decrease demand by decreasing contractility and HR

Question 10

Aspirin MOA

Answer 10

Prevents platelet activation/aggregation by decreasing thromboxane 2